chest conditions Flashcards
what is the cause of asthma?
inflammation of the bronchi leading to contraction of smooth muscle and mucus secretion
what triggers asthma?
cold air
animal fur
upper respiratory tract infection
pollution
what are s&s of asthma?
SOB
cough
tight chest
which tests are done for asthma?
spirometry
peak expiratory flow rate
what are the treatment options for asthma?
reliever inhalers (blue): relax the smooth muscles (short and long acting β2 agonist)
preventer inhalers (brown): reduce inflammation, oedema and mucus secretion (corticosteroids)
what conditions does COPD consist of?
emphysema: damaged alveoli, leading to alveolar collapse
chronic bronchitis: inflammation of the bronchi leading to a chronic cough
what is the primary cause of COPD?
smoking
what are the s&s of COPD?
SOB
coughing
breathlessness on exertion
use of accessory breathing muscles
pursed lips
hyper-inflated chest
reduced chest expansion
tachypnoeic (>20 breaths per minute)
downwardly placed liver
underweight
wheezing
which test is done for the diagnosis of COPD?
spirometry
what is the management for COPD?
refer to GP
advice of smoking
pulmonary rehabilitation
inhalers (same as asthma)
what is costochondritis?
inflammation of the cartilage (costo-chondral, sternal and clavicular)
what is the main cause of costochondritis?
upper respiratory tract infection
what are s&s for costochondritis?
anterior chest wall pain
sharp pain
worse on breathing, coughing, sneezing and physical activity
what is the treatment for costochondritis?
settles with time
contraindication for manipulation
what is angina?
chest pain caused by reduced blood flow to the heart
what is the difference between stable and unstable angina?
stable angina is precipitated by predictable factors
unstable angina occurs at any time
what are the s&s for angina?
discomfort in L chest, neck, shoulder, jaw and arm
precipitated by exertion/emotion
relieved by rest or Glyceryl Tri-Nitrate within 5 minutes
what is the diagnostic test for angina?
blood test for troponins
what is the management for angina?
lifestyle modification
medication: statins, glyceryl Tri nitrate, β blockers, nitrates
surgery: angioplasty, coronary bypass graft
what happens in a myocardial infarction?
reduced or complete cessation of blood flow to a portion of the myocardium
what are s&s for myocardial infarction?
crushing/tightness/heavy feeling in chest (someone sitting on chest)
pain in L chest, shoulder, jaw and arm (more painful than angina)
sweating, nausea, dyspnoea, fatigue, palpitations
what is the diagnostic test for MI?
blood test for troponins and creatine kinase
what is the management for MI?
lifestyle modification
aspirin
β blockers
ACE inhibitors
statins
omega 3
what are s&s of pancoast tumour?
unilateral persistent arm pain/numbness (commonly in upper medial arm and 4th and 5th digit)
weakness of hand
horner’s syndrome
persistent cough, SOB, fatigue, weightloss, night sweats
what is pericarditis?
inflammation of the pericardium (sac around the heart)
what is the main cause of pericarditis?
recent viral infection
what are the s&s for pericarditis?
proceeding viral symptoms: malaise, fever, muscle aches
pleuritic chest pain (sharp, stabbing, aching)
pain in shoulder arm and lower scapular
pleuritic rub on examination
what aggravates and reliefs the pain in pericarditis?
aggravates: lying down, inspiration and coughing
reliefs: leaning forward
what diagnostic test is used for pericarditis?
echocardiogram (shows fluid in the pericardial sac)
what is pneumonia?
acute inflammation of the alveoli and the terminal brochioles
what side effect can pneumonia have?
consolidation (fluid) in the lungs
what are s&s of pneumonia?
SOB at rest
cough
sputum with blood
weakness
malaise
muscle pain
signs of infection: fever, tachycardia, sweating
what might be found on respiratory examination in pneumonia?
signs of infection
decreased chest expansion on one side
absent breath sound on one side
dull percussion
auscultation: early: crackles, late: bronchial breathing
friction rub
what is a pneumothorax?
air trapped between lung and chest wall
what age group/population type is most at risk for pneumothorax?
young thin males
what are s&s of pneumothorax?
sudden, sharp, stabbing unilateral chest pain
SOB
pain worse on coughing and inspiration
what might be found on respiratory examination in pneumotharox?
unilateral decreased chest expansion
unilateral reduced/absent breath sound
unilateral hyper-resonant percussion
tachycardia
bronchial breathing (tubular sound, as if blown through a pipe)
what is the management for tension pneumothorax?
refer to A&E
what is a pulmonary embolis?
obstruction in the pulmonary arterial tree
what is the most common cause of a pulmonary embolism?
deep vein thrombosis
what are s&s of pulmonary embolism?
sharp/stabbing pleuritic chest pain
sudden SOB and pain
cough with blood
tachycardia
hypotension
increased respiratory rate
pleural rub
which tests are used for the diagnosis of pulmonary embolism?
D-dimer blood test
ultrasound
computed tomographic angiography
what is the managment for pulmonary embolism?
anticoagulants (heparin, oral coagulants)
prophylaxis
what are the symptoms of a rib fracture?
tenderness and swelling
local spasm
pain on breathing, coughing, sneezing (pleuritic sharp pain)
why do we need to refer patients with fractured rib to GP or A&E?
risk for pneumothorax and haemothorax
what is Tietze’s syndrome?
inflammation of the cartilage of the anterior portion of the chest
which ribs are most commonly affected in Tietze’s syndrome?
rib 2-3
what are s&s of Tietze’s syndrome?
pain and swelling of the costosternal, sternoclavicular or costochondral joints
pain resolves in weeks but swelling persists
